Psychological distress among young cancer survivors associated with heavy economic burden
Adolescents and young adult cancer survivors are more likely to have psychological distress and additional annual medical expenses than adults with no history of cancer, according to a study published in Cancer.
“Besides being a cancer researcher, I am an AYA [adolescent and young adult] cancer survivor and know from my personal and professional experience the struggles young cancer survivors face with our health care system. Some of these struggles are related to their physical and mental health, but others are related to the social and financial burden of disease,” Ola A. Abdelhadi, MBBCh, MPH, PhD, a post-doctoral researcher and fellow at UC Berkeley School of Public Health who conducted the research as part of a dissertation for a PhD degree in epidemiology at University of California, Davis, told Healio.
Abdelhadi and colleagues sought to quantify the additional medical expenditures and health care utilization associated with psychological distress among AYA cancer survivors.
Methodology
The analysis included 1,757 AYA cancer survivors and a matched sample of 5,227 adults with no history of cancer from 2011-2016 Medical Expenditure Panel Survey data. About two-thirds of the participants in each group were aged older than 40 years.
Among the cancer survivors, 202 had psychological distress (85.6% women) and 1,555 reported no psychological distress (79.3% women), whereas among those with no cancer history, 301 had psychological distress (84.7% women) and 4,926 did not (80% women).
Researchers used multivariable regression models to evaluate medical expenditures and health care utilization. They assessed psychological distress with the Kessler (K6) item questionnaire.
“In this paper I wanted to raise the awareness about the huge economic burden associated with having psychological distress among AYA cancer survivors,” Abdelhadi told Healio. “Health care interventions for this population may reduce health care use and expenses associated with psychological distress and improve quality of survivor’s psychological health.”
Key findings
Results showed a higher prevalence of psychological distress among AYA cancer survivors than those in the matched adult cohort with no history of cancer (11.5% vs. 5.8%; multivariable adjusted OR = 1.78; 95% CI, 1.37-2.4). Additionally, psychological distress among AYA cancer survivors significantly increased long after cancer diagnosis, with 11.2% of survivors reporting distress 20 years or longer after cancer diagnosis.
Analysis also showed AYA cancer survivors who reported psychological distress had a greater likelihood of being smokers (OR = 3.37; 95% CI, 1.89-6.04) and having chronic conditions (OR = 2.98; 95% CI, 1.19-7.46) and a lower likelihood of engaging in exercise regularly (OR = 2.22; 95% CI, 1.16-4.17) than AYAs with no psychological distress.
Psychological distress among cancer survivors led to additional annual medical expenses compared with survivors who had no distress ($4,415 vs. $1,802), as well as an average 2.8 (95% CI, 0.23-6.15) times more office visits and 11.58 (95% CI, 5.7-19.47) additional prescription medications/medication renewals.
Implications
The results suggest a “substantial need” for psychological care interventions among AYA cancer survivors both in the short- and long-term, Abdelhadi and colleagues wrote.
“We hope to inform survivorship care plans and guidelines to address the long-term psychological needs for AYA cancer survivors,” Abdelhadi told Healio. “Future studies should focus on identifying and comparing the effective interventions, money-wise and health-wise, that target psychological health of AYA cancer survivors.”
For more information:
Ola A. Abdelhadi, MBBCh, MPH, PhD, can be reached at Graduate Group of Epidemiology, University of California, Davis, 1 Shields Ave., Davis, CA 95616; email: oabdelhadi@ucdavis.edu.
Collapse